The incidence of food allergies and intolerances (including anaphylaxis), has increased dramatically in the last three decades. The exact cause of food allergy and sensitivity is unclear. There may be a genetic predisposition, but not in all cases.

Causes of Food Allergies, Intolerances & food sensitivities

Gut dysbiosis: compromises gut immunity, low beneficial bacteria, bacterial infections and pathogens, reduced digestive function and increase chance of intestinal permeability
Hygiene hypothesis: sterile, germ-free environments cause under-development of the immune system, which over-reacts when exposed to allergens. Allergies are much less common in rural environments.
Age of exposure / improper weaning: some theories suggest that children should be exposed earlier, while others propose that delaying exposure can decrease the incidence of allergies. Breastfeeding is a known preventative for development of food allergies. Early weaning of babies and introduction of grains and cow’s milk can give rise to the development of allergies and intolerances.
Chemical exposure: the use of pesticides and food additives creates a negative association with the food itself
Processing of food: the body cannot recognise altered proteins in GM or processed food.
Over-exposure: over-exposure to foods such as wheat and dairy may lead to the development of food intolerances
Poor nutrition: compromises immune system

Food allergy

IgE antibody-mediated reaction in which the body produces antibodies and histamine in response to the food.
Symptoms are relatively immediate, generally occurring within 2 hours of ingestion.
Only account for about 10% of food reactions
Generally allergic for life
The eight foods responsible for 90% of food allergies are milk, eggs, fish, shellfish, tree nuts, peanuts, wheat and soy.
Particularly involved in atopic diseases such as anaphylaxis, hives, allergic asthma, hay fever and atopic dermatitis (eczema).

Food sensitivity

A delayed form of reactivity, occurring up to 3-5 days after ingestion of food and lasting for a longer period of time
Mediated by IgA or IgG antibodies which form immune complexes that accumulate in tissues
Much more common than food allergy
Often dose-dependent and may be intermittent.
Often associated with compromised gut flora and integrity
The most common foods involved in sensitivity are casein, gluten, grains, eggs, nuts and legumes.

Food intolerance

All other negative reactions to food arising from non-antibody mediated factors, such as:

Enzyme deficiency e.g. lactose intolerance
Inability of the body to absorb nutrients e.g. fructose intolerance.
Chemical mediators in the food that cause dysregulation, inflammation or alteration of gut flora e.g. sugar, glutamates, salicylates, lectins, food additives, etc

Risk factors of food allergies, food intolerances and food sensitivities

Gut dysbiosis and intestinal permeability: increases the risk of absorption of larger food proteins which triggers an immune response
Family or personal history of allergies, asthma or atopic dermatitis
Under-exposure to germs and childhood infections early in life
Poor diet: deficient in nutrients and high in processed food
Over-eating and overexposure to certain foods
Stress
Drugs e.g. antibiotics, OCP, vaccines, alcohol
Exposure to chemicals and pollutants

Signs & Symptoms of food allergies, intolerances and sensitivities

Many and varied, depending on individual and type of allergy.

May include:

Skin: hives, angioedema, atopic dermatitis, psoriasis
GIT: mouth ulcers, bloating, cramping, flatulence, diarrhoea, constipation, nausea, vomiting, irritable bowel syndrome, inflammatory bowel disease
ENT: hoarse voice, sore throat, difficulty swallowing, ear infections, rhinitis, sinusitis
Respiratory: asthma, wheezing, shortness of breath, cough
Itching / swelling of lips, mouth, tongue and palate
Headaches
Muscle and joint pain
Fatigue
Insomnia
Mood changes: irritability, poor concentration, learning difficulties, depression
Puffiness or dark circles under eyes
Chronic swollen glands

Investigations for food allergies, sensitivities and intolerances

USA based CYREX array testing exclusively through Advanced Functional Medicine in Perth
IgG and IgA food panels
Stool analysis, SIBO breath test
Skin prick test: IgE-mediated reactions only
Elimination diet

TREATMENT STRATEGY

Investigate and identify gut issues – Stool analysis, SIBO breath test, intestinal permeability etc
Balance gut microbiome and treat intestinal permeability if indicated
Improve digestive function
Balance immune system / reduce allergic response
Reduce inflammation
Support adrenal function / manage stress

Diet plan guidelines for food allergies, food sensitivities & food intolerances

Identify / remove allergenic foods:

– May be done via food symptom diary, blood testing or elimination diet

– In true food allergy, the offending food may need to be removed for life

– In food sensitivities, the offending food may possibly be able to be reintroduced after 4-6 months at a low dose or on a rotation basis.

**Optimising gut function is critical before reintroduction of foods.

– Clients will need to be educated around appropriate substitutes and hidden sources of the allergen

Support digestive / liver function: bitter foods (rocket, radicchio, eggplant, lemon, artichoke); enzyme-containing foods (pineapple, papaya); apple cider vinegar and lemon juice with meals
Ideally follow an Autoimmune Paleo diet (AIP Diet). This diet removes the most common allergenic offenders from the diet

Supplements that support food allergy, sensitivities & intolerances

Vitamin C – inhibits histamine release, anti-allergy, immune, liver and adrenal support
Bioflavonoids (quercetin, bromelain) – stabilises mast cells, anti-histamine
Zinc – immune support, healing and repair of tissues, stomach acid production
Digestive enzymes: to support break down of food proteins
Pre- and probiotic supplement: to support healthy immune and digestive function and promote repair of intestinal lining
Glutamine – repair intestinal lining

Herbal medicine treatment that supports food allergy, sensitivities & intolerances

Anti-allergy: albizzia (stabilises mast cells), baical skullcap (inhibits PG, PAF, leukotrienes, histamine), chamomile, gingko (inhibits eosinophils and PAF), panax ginseng (inhibits histamine), licorice (inhibits histamine)
Immune modulation: echinacea, astragalus
Anti-inflammatory: turmeric (curcumin), ginger, boswellia – Studies show that curcumin has an antihistamine like effect and can target respiratory inflammation. If it helps reduce the frequency and severity of allergic reactions and asthma attacks (1)
Digestive stimulants: gentian, ginger
Repair / soothe gut wall: marshmallow, calendula, slippery elm, licorice, goldenseal, aloe

FUNCTIONAL MEDICINE TREATMENT OF FOOD ALLERGIES

Food allergies, sensitivities and intolerances can fly under the radar for many individuals for years on end. We commonly see in practice clients that have no idea that the foods they are consuming are causing such a negative reaction to their health.

Only by removing these foods and addressing underlying gut function do these patients realise how much of a negative impact the foods were having.

At our Perth clinic of Advanced Functional Medicine we have extensive experience in digestive disorders and dealing with patients with food allergies and intolerances. We use a range of investigative measures to pinpoint what foods are currently causing irritation.

Many foods can be reintroduced after a few months of abstinence combined with successful treatment of underlying gut dysbiosis and mucosa repair. By improving a patients overall gut health, intestinal permeability and digestion many foods that were previously highly irritable become tolerable again.

If you or a family member are suffering from food allergies and intolerances or have unexplained symptoms that may be caused by food intolerances we would love to hear from you, what symptoms are you having? Have you completed food intolerance testing, if so what type? After successful treatment, were you able to eat some of the foods you previously had an intolerance to? Please write a comment below.

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Food Allergies, Sensitivity & Intolerance – Symptoms, Causes & Natural Treatment